When we think of the hero in our hormone story, progesterone usually comes to mind. It’s the cooling, nourishing, calming feminine hormone that is the perfect balance to your estrogen. (Did you catch part 1 of the story on estrogen? Check it out here.)

What does progesterone do to benefit you? Many things, including:

• Contributes to proper sleep and decreasing anxiety
• Makes the uterus a really juicy and wonderful place for an egg to implant
• Nourishes your brain, supporting proper transmission of signals and protecting from injury after an accident
• Enhances serotonin (happiness) receptors in the brain
• Smooth muscle relaxant (‘involuntary’ muscles such as your uterus and lungs)
• Prevents endometrial cancer
• Up-regulates your thyroid function (but on the other hand, you need enough thyroid hormone [T3] to stimulate progesterone production, so low progesterone compounds a hypothyroid problem!)
• Helps to modulate the immune system and control autoimmune conditions

Progesterone is made by your ovaries after ovulation. Since ovulation (egg released from the ovaries) is the stimulation to start making progesterone, if you don’t ovulate, you don’t make progesterone. If you do ovulate each month, but your corpus luteum (tissue left over in the ovary once the egg is released) is not working correctly, it can release sub-par levels, or stop releasing progesterone before it’s supposed to—leaving you deficient and symptomatic!

What does low progesterone look like?

So what does it look like to be progesterone deficient? For many cycling women, this looks like awful PMS (premenstrual syndrome) with symptoms such as:

• breast tenderness
• moody/irritability
• heavy bleeding
• cramps
• clotting
• insomnia, migraines,
• and more.

Low progesterone can also be the cause of infertility, and recurrent miscarriages.

What causes your progesterone to decrease?

• Normal part of aging—ovarian function decreases & you stop ovulating. This can be from perimenopause and menopause.
• Premature ovarian failure: When you’re too young for menopause but your ovaries shut down function.
• Poor corpus luteum development (see above!).
• Brain miscommunication to the ovaries.
• When you have irregular cycle lengths, not ovulating, or skipping cycles.
• Extreme stress: When you’re stressed out, your brain slows down your reproduction. Evolutionary speaking, stressful times do not equal good times to bring a baby into the world!
• Low cholesterol: It’s the mother of all hormones—without it you don’t have anything to make your progesterone with!
• Overtraining (exercise): Not only can you burn up your stores of micronutrients if you’re not taking care of yourself, but over-exercising can be seen as a physiological stressor (see extreme stress above—plus check out my tips on evaluating your stress levels).
• Breast feeding: When you’re breastfeeding, your prolactin increases and decreases ovulation.
• Hypothryoidism (under-active thyroid).
• Polycystic ovarian syndrome (PCOS).
• Opioid pain medications.
• Hormonal birth control—pill, patch, ring, implant, injection, Mirena IUD
• Non-steroidal anti-inflammatories (NSAIDs): Found at your local pharmacy over the counter, NSAIDs such as Naproxen have been shown to suppress ovulation.
• Poor diet & nutrient deficiencies.
• Environmental toxins & chemical exposures.
• And more…

Although having too much progesterone is not unheard of, not having enough progesterone is more common. If you have too much progesterone, you could be getting symptoms such as water retention, acne, and breast tenderness. If you’re having trouble with too much progesterone, take a look at your prescriptions and supplements to evaluate if any of them are related to progesterone, as ‘overdosing’ yourself with progesterone stimulating products is the most common cause!

When you’re determining what’s what with your hormones, getting proper hormone testing is  imperative! As you read in part 1, estrogen dominance symptoms sound really similar to progesterone deficiency symptoms. So don’t just treat based on what you think it is; get yourself worked up!

Some really great information to bring to your integrative doctor’s appointment that can help determine what types of tests need to be ordered is:

• A cycle map: You can use an easy app on your phone to track cycle length, flow amounts, what symptoms you’re having on what day, and your basal body temperature.
• Birth control history: If you’ve taken birth control try to track down which prescription you were taking. Different brands use different formulations of hormones and this information can be helpful in determining what type of effect they can have.
• Your whole health history: You’ll be asked questions about your stress levels, gut function, chemical exposures, family history and more! Start brainstorming how you feel as a whole person so your provider can connect all the dots.

Next time on the hormone story…Testosterone! Stay tuned!

Dr. Cassie Wilder

Dr. Cassie Wilder is a registered Naturopathic Medical Doctor (NMD) and founder of MIMC. Her passion is empowering her patients through education, understanding, and support through their healing journey. After graduating from Iowa State University with a Bachelors of Science in Kinesiology and Health, Dr. Wilder earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine & Health Sciences, a fully accredited and nationally recognized institution in Phoenix, AZ. During her clinical training, she received extensive hands-on training with many leading experts in the field of functional medicine and developed a passion for treating hormonal imbalances, thyroid disorders, cardiovascular concerns, and adrenal fatigue.